Epidemiology and Health

Original Articles

Association of work-time control with burnout and turnover intention: a cross-sectional analysis of a general working population in Korea: Hye-Eun Lee, Seong-Sik Cho, Mo-Yeol Kang; Epidemiol Health. 2026;48:e2026011. Published online February 21, 2026; DOI: https://doi.org/10.4178/epih.e2026011

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
For employees, work-time control (WTC) may protect against burnout and turnover. However, evidence from Korean workplaces is limited. This study aimed to examine whether WTC is associated with burnout and turnover intention and to test whether burnout mediates this relationship.
METHODS
We analyzed data from 4,745 wage workers in the 2024 wave of the Korean Work, Sleep, and Health Study. WTC was assessed across 6 domains, burnout was measured using the Korean Burnout Syndrome Scale, and turnover intention was assessed using a validated 4-item scale. Logistic regression was used to estimate the associations of WTC quartile with burnout and turnover intention, and mediation analysis was used to decompose the association between WTC and turnover intention through burnout.
RESULTS
Among 4,745 workers, the prevalence of burnout was 3.9% and turnover intention was 34.5%; both increased stepwise across lower WTC quartiles. In adjusted models, workers in the lowest WTC quartile had higher odds of burnout (odds ratio [OR], 3.95; 95% confidence interval [CI], 2.41 to 6.47) and turnover intention (OR, 2.24; 95% CI, 1.85 to 2.71) than those in the highest quartile. Mediation analysis showed that burnout explained 36.6% (95% CI, 22.3 to 51.0) of the association between WTC and turnover intention.
CONCLUSIONS
Lower WTC was linked to higher burnout and turnover intention, with burnout explaining more than one-third of this relationship.; Summary

Korean summary
근로시간 통제(work-time control, WTC)가 낮을수록 한국 노동자에서 번아웃과 이직 의도가 더 높게 나타났다. WTC가 가장 낮은 집단은 가장 높은 집단에 비해 번아웃 위험이 약 4배, 이직 의도는 약 2배 이상 높았다. 번아웃은 WTC와 이직 의도 사이 연관성의 약 36.6%를 매개하여, 근로시간 자율성을 높이는 것이 번아웃을 줄이고 이직 의도를 낮추는 데 기여할 수 있음을 시사한다.

Key Message
Lower work-time control (WTC) was associated with higher burnout and greater turnover intention among Korean workers. Workers in the lowest WTC quartile had nearly four times higher odds of burnout and more than twice the odds of turnover intention compared with those in the highest quartile. Burnout mediated about 36.6% of the association between WTC and turnover intention, suggesting that improving schedule control may reduce turnover partly by preventing burnout.

Association between psychosocial safety climate and depression risk among Korean workers: Soo Kyung Cho, Seong-Sik Cho, Maureen F. Dollard, May Young Loh, Mo-Yeol Kang; Epidemiol Health. 2025;47:e2025044. Published online August 13, 2025; DOI: https://doi.org/10.4178/epih.e2025044

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Abstract Summary PDF: Abstract
OBJECTIVES
Psychosocial safety climate (PSC) reflects an organization’s commitment to safeguarding workers’ psychological health and safety. While international evidence links low PSC to poor mental health outcomes, its association with depression has not been well established in Korea. This study aimed to examine the relationship between PSC and depression among Korean workers, utilizing a large-scale, population-based survey.
METHODS
We analyzed data from 5,337 wage employees who participated in the fifth wave of the Korean Work, Sleep, and Health Study. Depression was measured using the 9-item Patient Health Questionnaire, and PSC was assessed with a validated 4-item scale. Participants were classified into low-risk, intermediate-risk, and high-risk groups based on their PSC scores. Multivariable logistic regression was conducted to estimate the association between PSC and depression, with stratified analyses performed according to gender, age, and occupational characteristics.
RESULTS
The prevalence of depression increased as PSC scores decreased. Compared to the low-risk group, the intermediate-risk and high-risk PSC groups exhibited 1.19 times and 2.69 times higher risks of depression, respectively, suggesting a clear exposure-response relationship. Stratified analyses indicated that associations were stronger among individuals without union representation or access to occupational health and safety resources.
CONCLUSIONS
These findings underscore the critical role of PSC in workplace mental health. Promoting a high PSC may help reduce depression risk and support mental well-being among workers. Interventions considering vulnerable subgroups are warranted to create psychologically safer work environments in Korea.; Summary

Korean summary
-본 연구에서는 한국 근로자에서 심리사회적 안전풍토(PSC) 점수가 낮을수록 우울 위험이 유의하게 높아짐을 확인하였다. -PSC 중간위험군과 고위험군의 우울 위험은 저위험군에 비해 각각 1.19배, 2.69배 높았다. -연구 결과는 근로자의 정신건강 증진과 국가적 정책 수립을 위해 직장에서의 PSC 강화를 강조한다.

Key Message
-This study demonstrates that lower psychosocial safety climate (PSC) scores are associated with a significantly higher risk of depression among Korean workers. -The risk of depression was 1.19 times higher in the intermediate-risk PSC group and 2.69 times higher in the high-risk PSC group compared with the low-risk group. -Findings highlight the importance of strengthening PSC in workplaces to improve employee mental health and guide national policies.

Associations of self-rated health, depression, and work ability with employee control over working time: Heejoo Ko, Seong-Sik Cho, Jaesung Choi, Mo-Yeol Kang; Epidemiol Health. 2025;47:e2025036. Published online July 8, 2025; DOI: https://doi.org/10.4178/epih.e2025036

5,563 View
81 Download
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Abstract Summary PDF

Abstract

OBJECTIVES
Work-time control (WTC), defined as employees’ ability to influence their work schedules, is a crucial determinant of work-life balance and well-being. This study aims to evaluate the associations between WTC and health-related outcomes among Korean workers and examine potential effect modifications by working hours and shift work status.

METHODS

This study analyzed data from the 2024 wave of the Korean Work, Sleep, and Health Study, a nationwide panel study of workers aged 19 years to 70 years (n=5,195). WTC was measured using a 6-item scale, and participants were categorized into low (≤12) or high (>12) WTC groups. Outcomes included self-rated health (SRH), depression (measured by the Patient Health Questionnaire-9), and work ability (WA; measured by the Work Ability Index). Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for poor SRH, moderate-to-severe depression, and poor WA, adjusting for demographic and occupational variables. Subgroup analyses assessed effect modifications by working hours and shift work.

RESULTS

Higher WTC was associated with lower odds of poor SRH (OR, 0.73; 95% CI, 0.62 to 0.86), moderate-to-severe depression (OR, 0.71; 95% CI, 0.61 to 0.83), and poor WA (OR, 0.62; 95% CI, 0.46 to 0.84). These associations were significant among daytime workers but not shift workers. The protective effects of WTC were attenuated among workers whose working hours exceeding 52 hr/wk.

CONCLUSIONS

Higher WTC is associated with better health and work outcomes, emphasizing its importance for employee well-being. However, its benefits may be limited among shift workers and employees working excessive hours.

Summary

Korean summary
- 근로시간 통제권(WTC)이 높은 근로자는 주관적 건강상태가 더 좋고, 우울 위험이 낮으며, 근로능력이 높은 것으로 나타났다. - 이러한 보호 효과는 주간 근로자에서만 유의하였으며, 근로시간이 주 52시간을 초과할 경우 효과가 약화되었다.

Key Message
- Higher work-time control (WTC) was associated with better self-rated health, lower risk of depression, and improved work ability among Korean workers. - The protective effects of WTC were significant for daytime workers but not for shift workers, and benefits diminished when weekly working hours exceeded 52.

Citations

Citations to this article as recorded by

Association of work-time control with burnout and turnover intention: a cross-sectional analysis of a general working population in Korea
Hye-Eun Lee, Seong-Sik Cho, Mo-Yeol Kang
Epidemiology and Health.2026; : e2026011. CrossRef

Association between the safety climate and occupational injury in the Korean working population: a cross-sectional study: Jeehee Min, Tae-Won Jang, Hye-Eun Lee, Mo-Yeol Kang, Seong-Sik Cho; Epidemiol Health. 2024;46:e2024082. Published online October 1, 2024; DOI: https://doi.org/10.4178/epih.e2024082

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218 Download
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3 Crossref

Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Preventing occupational injuries remains a significant challenge in Korea. A positive safety climate can contribute to reducing workplace injuries. However, the impact of safety climate on preventing occupational injuries among the Korean workforce has not been adequately explored. Therefore, this study aimed to investigate the relationship between the perceived safety climate and occupational injuries within the Korean working population.

METHODS

This study used baseline data from the Korean Work, Sleep, and Health Study (KWSH). The safety climate was measured using the brief version of the Nordic Safety Climate Questionnaire. Occupational injury was determined by whether injuries or accidents had occurred at workplaces in the past year. Logistic regression analysis was performed to examine the association between the safety climate and occupational injury.

RESULTS

Participants who reported an unfavorable workplace safety climate were more likely to experience occupational injuries. Multiple logistic regression analysis revealed that the adjusted odds ratio (OR) for occupational injuries in an unfavorable safety climate was 2.20 (95% confidence interval [CI], 1.38 to 3.51) compared to a favorable safety climate. Specifically, factors such as “not encouraging employees to follow safety rules when on a tight schedule” (OR, 2.02; 95% CI, 1.25 to 3.24) and “not helping each other work safely” (OR, 1.98; 95% CI, 1.17 to 3.25) were significantly associated with occupational injuries.

CONCLUSIONS

An unfavorable safety climate was associated with increased occupational injuries among Korean workers. Improving the safety climate in the workplace may reduce occupational injuries in Korea.

Summary

Korean summary
한국 노동인구집단에서도 안전풍토는 직업성 손상과 관련성이 관찰되었다. 이 같은 결과는 작업장의 안전풍토를 개선함으로써 직업성 손상을 예방할 수 있음을 시사한다.

Key Message
Safety climate was related to occupational injuries in the Korean working population. This result may indicate that occupational injuries can be prevented by improving the workplace safety climate. Workplace safety should be a high priority goal for management, and workers need to help each other for workplace safety.

Citations

Citations to this article as recorded by

Data profile: Korean Work, Sleep, and Health Study (KWSHS)
Seong-Sik Cho, Jeehee Min, Heejoo Ko, Mo-Yeol Kang
Ann Occup Environ Med.2025; 37: e3. CrossRef
Safety Climate and Occupational Injuries in the Iron and Steel Industries in Tanzania
Saumu Shabani, Bente Elisabeth Moen, Teferi Abegaz, Simon Henry Mamuya
International Journal of Environmental Research and Public Health.2025; 22(9): 1372. CrossRef
Association between safety climate, safety participation, safety compliance, and occupational injuries among workers in large-scale building construction projects in Ethiopia
Teferi Abegaz, Wakgari Deressa, Bente E. Moen
International Archives of Occupational and Environmental Health.2025; 98(7): 685. CrossRef

The physical activity paradox in relation to work ability and health-related productivity loss in Korea: Heejoo Ko, Dohwan Kim, Seong-Sik Cho, Mo-Yeol Kang; Epidemiol Health. 2023;45:e2023096. Published online October 28, 2023; DOI: https://doi.org/10.4178/epih.e2023096

17,299 View
289 Download
6 Web of Science
7 Crossref

Abstract PDF

Abstract

OBJECTIVES
The physical activity paradox suggests that occupational physical activity (OPA), unlike leisure-time physical activity (LTPA), may detrimentally impact health. We explored the relationships of OPA and LTPA with work ability (WA) and health-related productivity loss (HRPL).

METHODS

This study included 5,501 workers in Korea who were recruited in 2021 through a web-based cross-sectional questionnaire. The questionnaire was utilized to quantify OPA and LTPA in metabolic equivalents, while WA and HRPL were also measured. Non-parametric regression, using a generalized additive model (GAM), was employed to visualize the relationships of LTPA and OPA with WA and HRPL. Mean differences in WA and HRPL, in relation to OPA and LTPA, were examined using linear regression models. These models were adjusted for covariates including sex, age, body mass index, education level, alcohol consumption, smoking history, insomnia, occupation, hours worked, and income.

RESULTS

The GAM and linear regression analyses revealed that higher LTPA corresponded with higher WA and lower HRPL. In contrast, as OPA increased, WA decreased and HRPL increased. However, within the group with high OPA, HRPL was not significantly lower in the high-LTPA subgroup relative to the low-LTPA subgroup (mean difference=1.92%, p=0.343). This pattern was especially pronounced among workers aged 60 years and older, with an increase in HRPL observed with increasing LTPA among the respondents with high OPA.

CONCLUSIONS

High LTPA levels were associated with elevated WA and diminished HRPL. In contrast, higher levels of OPA were associated with lower WA and higher HRPL.

Summary

Citations

Citations to this article as recorded by

Domain-Specific Physical Activity and Obesity Risk among Black Men in the United States: Evidence of a Physical Activity Paradox
Ailton Coleman, Jerraco L. Johnson, Jamila L. Kwarteng, Ahondju U. Holmes, Roland J. Thorpe, Elizabeth Heitman
Journal of Racial and Ethnic Health Disparities.2026;[Epub] CrossRef
Association of leisure-time physical activity at different phases of life with work ability at the end of working life: a Finland-representative 45-year prospective cohort study
Perttu Laakso, Francisco B Ortega, Asko Tolvanen, Timo Jaakkola
British Journal of Sports Medicine.2026; 60(8): 583. CrossRef
Data profile: Korean Work, Sleep, and Health Study (KWSHS)
Seong-Sik Cho, Jeehee Min, Heejoo Ko, Mo-Yeol Kang
Ann Occup Environ Med.2025; 37: e3. CrossRef
Association between work stress and sleep disturbances: the mediating role of pre-sleep arousal symptoms
Jeehee MIN, Hoje RYU, Seong-Sik CHO, Mo-Yeol KANG
Industrial Health.2025; 63(5): 478. CrossRef
Understanding the Link Between Physical Activity and Work Ability in University Staff: Protocol for a Gender-Sensitive Cross-Sectional Study
Laura Lorenzo-Gallego, Silvia Muñoz-Pastor, Maria Remedios Menéndez-Calvo, Beatriz Navarro-Brazález, María Torres-Lacomba
JMIR Research Protocols.2025; 14: e80298. CrossRef
THE ROLE OF PHYSICAL ACTIVITY IN THE TREATMENT OF HASHIMOTO’S THYROIDITIS – A LITERATURE REVIEW
Wiktoria Knobelsdorf, Wiktor Daniszewski, Gabriela Furtak, Maria Łagódka, Michał Pogoda, Katarzyna Zając, Dominika Pietrzyk, Bartosz Oder, Maciej Ćmil, Wojciech Karchut
International Journal of Innovative Technologies in Social Science.2025;[Epub] CrossRef
Association between the safety climate and occupational injury in the Korean working population: a cross-sectional study
Jeehee Min, Tae-Won Jang, Hye-Eun Lee, Mo-Yeol Kang, Seong-Sik Cho
Epidemiology and Health.2024; 46: e2024082. CrossRef

The association between occupational stress level and health-related productivity loss among Korean employees: Jonghee Chung, Jin-Hyo Kim, Jae Yoon Lee, Hee Seok Kang, Dong-wook Lee, Yun-Chul Hong, Mo-Yeol Kang; Epidemiol Health. 2023;45:e2023009. Published online December 28, 2022; DOI: https://doi.org/10.4178/epih.e2023009

21,178 View
378 Download
6 Web of Science
8 Crossref

Abstract Summary PDF

Abstract

OBJECTIVES
Occupational stress management is particularly important for successful business operations, since occupational stress adversely affects workers’ health, eventually lowering their productivity. Therefore, this study aimed to investigate the correlation between occupational stress and health-related productivity loss (HRPL) among Korean workers.

METHODS

In 2021, 1,078 workers participated in a web-based questionnaire survey. HRPL was measured using the Work Productivity and Activity Impairment Questionnaire, and occupational stress was measured using the Korean Occupational Stress Scale-Short Form. The occupational stress level was divided into tertiles (low, intermediate, and high), and the low occupational stress group was used as the reference group. Using a generalised linear model, differences in labour productivity loss according to the level of occupational stress were tested after adjusting for demographic characteristics such as age, gender, education level, household income, occupation, and underlying medical conditions.

RESULTS

Non-parametric regression analysis of HRPL according to occupational stress showed a direct association between occupational stress and HRPL. A statistically significant difference was observed in HRPL between participants with intermediate and high occupational stress and those with low occupational stress.

CONCLUSIONS

Our results support the hypothesis that high occupational stress is associated with decreased labour productivity.

Summary

Korean summary
직무스트레스가 건강에 미치는 영향은 잘 알려져 있으나, 노동생산성에 대해 분석한 결과는 그동안 부족하였다. 한국 노동자 1078명을 분석한 결과, 직무스트레스가 낮은 군에 비해서 중등도이거나 높은 경우, 결근이나 프리젠티즘과 같은 건강관련 노동생산성 손실이 약 20%p 정도 높은 것으로 분석되었다.

Key Message
As a result of analyzing 1078 Korean workers, it was revealed that health-related labor productivity losses such as absenteeism and presenteeism were about 20%p higher when occupational stress was moderate or high compared to the low occupational stress group.

Citations

Citations to this article as recorded by

Design and Proof-of-Concept Evaluation of a Gamified Virtual Reality System for Short-Term Work Stress Reduction
Ioannis Ladakis, Henar Guillen-Sanz, Despoina Xanthopoulou, Ioanna Chouvarda
IEEE Access.2026; 14: 30164. CrossRef
Do Females and Males Experience Occupational Stress Differently? Insights from a Meta-Analysis
Siu Shing Man, Yizhen Fang, Yingwei Chen, Li Liu, Alan Hoi Shou Chan
Safety and Health at Work.2026;[Epub] CrossRef
Occupational stress(KOSS®19): scale development and validation in the Korean context
Hansoo Song, Hyoung Ryoul Kim, Inah Kim, Jin-Ha Yoon, Sang-Baek Koh, Sung-Soo Oh, Hee-Tae Kang, Da-Yee Jeung, Dae-Sung Hyun, Chunhui Suh, Sei-Jin Chang
Annals of Occupational and Environmental Medicine.2025; 37: e12. CrossRef
Impact of Medical Technologist’s Working Environment on Health Problems: Using Data from the 6th Korean National Health and Nutrition Examination Survey
Taewon JUNG, Miran LEE, Sang-ha KIM, Sunghyun KIM, Young-Kwon KIM
Korean Journal of Clinical Laboratory Science.2025; 57(2): 189. CrossRef
The mediating role of burnout in the association between occupational stress and health-related productivity loss
Eun KIM, Hyoung-Ryoul KIM, Sangjun CHOI, Hyun A CHO, Seong-Sik CHO, Mo-Yeol KANG
Industrial Health.2025; 63(6): 557. CrossRef
Association between work from home and health-related productivity loss among Korean employees
Hyo Jeong Kim, Dong Wook Lee, Jaesung Choi, Yun-Chul Hong, Mo-Yeol Kang
Annals of Occupational and Environmental Medicine.2024;[Epub] CrossRef
The association between salivary IL-6 and poor sleep quality assessed using Apple watches in stressed workers in Japan
Akihiro Koreki, Mitsuhiro Sado, Yasue Mitsukura, Hisateru Tachimori, Anna Kubota, Yoshiaki Kanamori, Manae Uchibori, Shiyori Usune, Akira Ninomiya, Ryutaro Shirahama, Akihiro Fujimoto, Kanako Inabe, Hiroaki Miyata, Masaru Mimura
Scientific Reports.2024;[Epub] CrossRef
The association of emotional labor and workplace violence with health-related productivity loss
Heejoo Ko, Dohwan Kim, Seong-Sik Cho, Dong-Wook Lee, Jaesung Choi, Minseok Kim, Min Young Park, Mo-Yeol Kang
Journal of Occupational Health.2024;[Epub] CrossRef

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